With Dr. Suri’s experience in hip arthroscopy as a surgeon, educator and researcher, many of Dr. Suri’s hip arthroscopy patients often have common questions. This is an effort to answer many of these questions to help you in your planning before and after surgery.
- When can we schedule the surgery ?
- You said you were going to "release" the iliopsoas tendon. What does that mean? Are you going to cut it and then it needs to re-heal?
- While on crutches will I be in some type of brace? Restricting movement of the hip will be difficult. Will I be able to sit down in a chair or do I need stay lying down?
- How long will I be in the hospital after surgery?
- You mentioned I have to go into Rehab the afternoon on the day after surgery. Will I be able to go up/down stairs and get into a car to get to rehab?
- I will need to climb steps at my house, is this going to be a problem (other than getting used to crutches)?
- Do you recommend any particular Physical Therapist or Rehab facility?
- Do I continue to go to Rehab 2-3 x per week while on crutches for the 1st 2-3 wks?
- Approx how many days post surgery will my follow up with you be?
- I have to get on a plane a month after surgery, will this be a problem?
- I have a family vacation scheduled for 6 weeks after surgery, will I be able to walk around the cities, swim in the ocean, etc?
- What is my rehab going to be after surgery?
- Are there any contraindications with my hip range of motion (ROM) post surgery? If so what are they?
- How soon after surgery can I shower?
- Should I put ice on my hip after surgery?
- What should I do if I have to take a long drive home after surgery?
- When can I drive after surgery?
Generally, hip arthroscopies are booked several weeks to 1-2 months in advance. At Ochsner, Dr. Suri performs hip arthroscopies on Tuesdays, due to operating room availability. At Children’s, hip arthroscopies are done on Fridays.
You said you were going to "release" the iliopsoas tendon. What does that mean? Are you going to cut it and then it needs to re-heal?
Yes, I will release the psoas tendon (the overlying muscle fibers remain intact). There should not be any functional deficit, as the psoas heals in a few weeks and strength returns (we know psoas strength returns from prior studies on the psoas tendon). The psoas tendon is a pain generator in the hip, that if not released can result in incomplete pain relief.
While on crutches will I be in some type of brace? Restricting movement of the hip will be difficult. Will I be able to sit down in a chair or do I need stay lying down?
After surgery, you will typically be on crutches with partial (25%) weight bearing for 2 weeks. You will also be in a special hinged hip brace. You will be able to (and are encouraged to) move and walk with the brace. The brace is to be worn while awake for 10 days. The brace is used in the early stages of healing. You will also be in foam boots with a foam pillow attached to you feet. These boot and pillow are to be worn while sleeping for 14 days. The boots and pillow are also used to help the hip and capsule heal early on and are important to wear.
Most patients go home the same day after surgery. As it is easier to have a bed reserved in the hospital, rather than try to get one at the last minute, patients have provisions to stay overnight. On the afternoon/evening of surgery, most patients are eager to go home and can do so by letting the nurses know that you wish to go home.
You mentioned I have to go into Rehab the afternoon on the day after surgery. Will I be able to go up/down stairs and get into a car to get to rehab?
Yes, with some difficulty at first, but you should be able to manage slowly.
I will need to climb steps at my house, is this going to be a problem (other than getting used to crutches)?
You will be able to do slowly.
Physical therapy after hip arthroscopy is very important to your recovery. Certain physical therapists have more experience with the special rehabilitation that is needed after hip arthroscopy. I will almost always direct you to a therapist that has experience with the rehabilitation after hip arthroscopy. If there is not one in your area, the physical therapist that you go to will need to be in close contact with our physical therapists at Ochsner Sports Medicine, as they have quite a bit of experience with the specific needs for rehabilitation after hip arthroscopy. The physical therapist will also be provided with a detailed therapy protocol to follow and can contact our therapists experienced in hip arthroscopy rehabilitation at Ochsner Sports Medicine, for questions.
Yes, rehab is 1-2x /week for first 2-3 weeks, then 2-3x/week and will continue for 2-4 months, with a probable decrease in frequency later on in the therapy protocol. The home program that you will be instructed on, that occurs in between physical therapy visits remains a very important part of the rehabilitation.
About 17-19 days after surgery. Sutures will be removed at this visit. For Dr. Suri’s patients that live far away, sutures can be removed by a physician locally and we can communicate by phone.
You should be ok to get on plane for a domestic trip by 4-6 weeks after surgery. If you are taking a trip, I would advise taking two 325 mg aspirin tablets a day, for the week before the trip and a week after, to minimize the risk of blood clots, which will be already very low, as you will be quite active. Also, wearing TED hose is advised as well.
I have a family vacation scheduled for 6 weeks after surgery, will I be able to walk around the cities, swim in the ocean, etc?
Swimming in a pool will be ok (be careful on slippery surfaces), leg endurance may be a low for walking distances, but some walking will be fine.
In general, activity progresses post-operatively with stationary biking immediately, elliptical at 7 weeks, running at 9 weeks, return to play at 3-4 months.
You will probably have some episodes of mild pain, especially in front of the hip. This can occur with advances in rehabilitation levels. This is common around the 6-10 week range postoperatively. This is normal and part of the healing process of your hip.
Are there any contraindications with my hip range of motion (ROM) post surgery? If so what are they?
Flexion: 90° x 10 days
Extension: gentle x 3 wks
Abduction: 25° x 3 wks
External Rotation: gentle x 3 wks
Internal Rotation: no limits
Can I cross my legs? Yes
3 days after surgery you can shower with big band-aids over the incisions. Avoid bathing/soaking underwater until the incisions heal completely, typically about 3 weeks.
Under your brace, you will have a cooling pad that will be next to your hip. This pad is connected to a small ice chest. It is a device that circulates cool water to the pad that safely functions to provide cold therapy to the area. This device will go home with you. Almost all of my patients really like the cold therapy.
For Dr. Suri’s patients that live far away, you generally will be in the hospital overnight and will be able to go home the next morning. If you live far away, the car ride may be a little tough, but time the travel to start just after taking a couple of pain pills. Also, it is a good idea to get a car adapter for the cooling machine and pad that will be next to your hip. You will need a car charger adapter that you can plug the cooling machine into. The cooling machine is the size of a small ice chest. It will be good to have the cold therapy while you are in the car for the ride home. Also, wearing TED hose is advised as well.
Narcotics are no different than being under the influence of ETOH. This can be detected when tested. So, do not drive while taking any narcotics. When past this stage, travel to an empty parking lot or cul-de-sac and switch drivers to see if you are competent. The average time not driving following hip arthroscopy is between 2 and 4 weeks, also depending on operative side. I do not recommend driving at least until after the brace is off.